Erika Martinez
Rio Rancho,NM
Summary
Objective Revenue Integrity leader with demonstrated success leading financial systems and programs. Knowledgeable about regulatory requirements and successful strategies for maintaining optimal controls. Well-organized, proactive and adaptable to changing markets.
Overview
20
20
years of professional experience
1
1
Certification
Work History
Assistant Vice President, Revenue Integrity
Trinity Healthcare Resources
01.2023 - Current
- Advisor to software development company, developing AI for revenue recovery within multi-facility organizations
- Reviewed, identified, updated and prioritized strategic initiatives to provide comprehensive support to senior leadership.
- Revenue Cycle management consultant managing financial aspects including billing, claims, processing, payment collection, chargemaster and charge audits.
- Implemented data-driven decision-making processes, leading to more informed strategic choices and improved overall performance metrics.
- Fostered strong relationships with key clients, leading to repeat business and a significant increase in customer satisfaction ratings.
Corporate Director, Revenue Management
Ardent Health Services
02.2004 - 12.2022
- Developed and deployed corporate policies and procedures related to Revenue Integrity to ensure compliance with charging and documentation requirements
- Identify and implement enterprise-wide Revenue Integrity best practices for risk management and compliance, ensuring adherence to regulatory standards
- Enhanced company productivity standards for both internal staff and vendors, by implementing streamlined operational processes and workflow systems.
- Managed Revenue Cycle candidate for bill calls with senior leadership reviewing KPIs and performance benchmarks
- Work in partnership with billing to report and reduce AR aging days, denials, and bad debt write offs
- Report, trend, and analyze revenue flow for multiple hospitals for financial reporting, late charges, edits, and denials
- Maintain open line of communication with financial and clinical leadership for questions and education opportunities
- Perform external and internal charge audits for insurance, defense, OIG, RAC, and MAC
- Led and partnered with multi-disciplinary team of chargemaster experts, Nurse Auditors, coders, HIM professionals, clinicians, and financial teams through several core financial and clinical application conversions
- Championed relationships with IT development and IT architect teams to insure transactions and data flow smoothly
- Responsible for in-depth testing and reporting outcomes throughout conversion process and presented to senior leadership throughout the life of the project
- Key contributor to technology strategies involving multiple applications while managing in-house and outside vendor resources to meet aggressive and accelerated timelines
- Oversee all enterprise conversion to Epic chargemaster activities including IT system maintenance of tables, router, etc
- Effectively led core conversion to standardize chargemasters of multiple hospitals
- Implemented enterprise-wide IT maintenance protocols and streamlined all activities moving from a decentralized process to a centralized process
- Partnered with corporate and hospital finance teams to standardize GL chart of accounts related to Epic driven patient revenue
- Direct oversight of pre-bill edits, chargemaster, and nurse audit teams.
- Recruited, trained, mentored and engaged highly successful operations leadership team.
- Fostered a culture of continuous improvement by encouraging employee feedback and implementing actionable changes based on their input.
- Streamlined communication channels between departments to facilitate collaboration and improve decision-making processes.
Education
Bachelor of Arts - Health Information Administration
University of Cincinnati
Skills
- Epic System Conversion Management
- Clinical Application Deployment
- EMR Implementation
- Project Management
- Revenue Integrity/Management
- Organizational Leadership
- Coding Management
- High-level Analysis
- Audit Planning and Execution
- Strategic Planning
- Customer Service
Certification
- Registered Health Information Administrator (RHIA) , The American Health Information Management Association (AHIMA)
- Certified Revenue Cycle Representative (CRCR), Healthcare Financial Management (HFMA)
- Epic- Resolute Hospital Revenue Integrity Management
- Epic- Resolute Hospital Charge Description Master
- Epic- Charge Router
- Epic- Post Go-live Reporting
Timeline
Assistant Vice President, Revenue Integrity
Trinity Healthcare Resources
01.2023 - Current
Corporate Director, Revenue Management
Ardent Health Services
02.2004 - 12.2022
Bachelor of Arts - Health Information Administration
University of Cincinnati
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